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CK Heme Onc > General Neoplasia > Flashcards

General Neoplasia Flashcards

1
Q

Nodules of cancer frequently display central necrosis (umbilication). Causes of tumor cell death in situ include 1. apoptosis 2. ischemia 3. paucity of nutrients 4. vulnerability to host defenses

A

Causes of tumor cell death in situ include 1. apoptosis 2. inadequate blood supply & ischemia 3. a paucity of nutrients 4. vulnerability to specific and non-specifc host defenses

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2
Q

_____ is a tumor marker for

  1. adenocarcinomas of the colon
  2. malignant tumors of the pancreas, lung, and ovary
A

CEA is a tumor marker for

  1. adenocarcinomas of the colon
  2. malignant tumors of the pancreas, lung, and ovary
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3
Q

Neuroendocrine tumors can be identified by their content of _____.

A

Neuroendocrine tumors can be identified by their content of chromogranins.

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4
Q

_____ is expressed by hepatocellular and yolk sac tumors.

A

AFP is expressed by hepatocellular and yolk sac tumors.

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5
Q

Chorionic gonadotropin is secreted by ___carcinomas.

A

Chorionic gonadotropin is secreted by choriocarcinomas.

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6
Q

Tumor marker for soft tissue sarcomas. An intermediate filament.

A

Vimentin

Tumor marker for soft tissue sarcomas. An intermediate filament.

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7
Q

Malignant lymphomas are generally positive for _____.

A

Malignant lymphomas are generally positive for leukocyte common antigen (LCA).

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8
Q

Hypermethylation is an example of _____ modification.

Hypermethylation of many _____ _____ and _____ _____ genes has been demonstrated in human tumors, including the p53 pathway.

Unlike genetic changes in cancer, epigenetic changes are reversible.

A

Hypermethylation is an example of epigenetic modification.

Hypermethylation of many tumor supressor and DNA repair genes has been demonstrated in human tumors, including the p53 pathway.

Unlike genetic changes in cancer, epigenetic changes are reversible.

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9
Q

_____ are benign tumors composed of tissues from all three primary germ layers: ectoderm, mesoderm, endoderm.

They are most common in the ovary, testis, and extragonadal sites.

They contain a variety of structures – skin, neurons, glial cells, cartilage, glandular epithelium.

A

Teratomas are benign tumors composed of tissues from all three primary germ layers: ectoderm, mesoderm, endoderm.

They are most common in the ovary, testis, and extragonadal sites.

They contain a variety of structures – skin, neurons, glial cells, cartilage, glandular epithelium.

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10
Q

_____ are malignant tumors that harbor embryonal carcinoma stem cells.

A

Teratocarcinomas are malignant tumors that harbor embryonal carcinoma stem cells.

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11
Q

Localized, disordered differentiation during embryonic development results in a _____, a disorganized caricature of normal tissue components such as cartilage, blood vessels, lymphoid tissue, ducts or bronchi.

A

Localized, disordered differentiation during embryonic development results in a hamartoma, a disorganized caricature of normal tissue components such as cartilage, blood vessels, lymphoid tissue, ducts or bronchi.

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12
Q

Cancer Epidemiology - what country is associated with each cancer?

Stomach cancer: _____

Colorectal cancer: _____

Prostate cancer: _____

A

Cancer Epidemiology

Stomach cancer: Japan

Colorectal cancer: United States

Prostate cancer: American blacks

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13
Q

Disease: _____ _____

  • autosomal recessive
  • increased sensitivity to UV radiation
  • pyrimidine dimers
  • high incidence of skin cancer
  • germline mutations in gene encoding nucleotide excision repair enzyme
A

Xeroderma Pigmentosum

  • autosomal recessive
  • increased sensitivity to UV radiation
  • pyrimidine dimers
  • high incidence of skin cancer
  • germline mutations in gene encoding nucleotide excision repair enzyme
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14
Q

Li-Fraumeni syndrome

Germline mutations of _____ lead to inherited predisposition to develop cancers in many organs. The gene functions in transcriptional regulation.

A

Li-Fraumeni syndrome

Germline mutations of p53 lead to inherited predisposition to develop cancers in many organs. The gene functions in transcriptional regulation.

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15
Q

_____ _____

  • mutation in ATM gene, which codes for a nuclear phosphoprotein involved in cell cycle regulation and DNA repair
  • cerebellar degeneration
  • immunologic abnormalities
  • predisposition to cancer
A

Ataxia telangiectasia

  • mutation in ATM gene, which codes for a nuclear phosphoprotein involved in cell cycle regulation and DNA repair
  • cerebellar degeneration
  • immunologic abnormalities
  • predisposition to cancer
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16
Q

Most common causes of death from cancer in women:

  1. _____
  2. _____
A

Most common causes of death from cancer in women:

  1. Lung cancer
  2. Breast cancer
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17
Q

_____-_____ anemia is common in cancers that bleed into the GI tract, such as colorectal cancer.

A

Iron-deficiency anemia is common in cancers that bleed into the GI tract, such as colorectal cancer.

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18
Q

c-abl protooncogene on chromosome 9 t(9,22) –> _____ _____ _____

A

c-abl protooncogene on chromosome 9 t(9,22) –> chronic myelogenous leukemia

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19
Q

Neuroblastomas
small cell carcinoma of the lung
Wilms tumor
hepatoblastoma

are all associated with gene amplification of _____-family protooncogenes

A

Neuroblastomas
small cell carcinoma of the lung
Wilms tumor
hepatoblastoma

are all associated with gene amplification of myc-family protooncogenes

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20
Q

Breast cancer and Ovarian cancer are associated with gene amplification of the Erb2 or ___/___ protooncogene

A

Breast cancer and Ovarian cancer are associated with gene amplification of the Erb2 or HER2/neu protooncogene

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21
Q

C-sis protooncogene encodes _____

–associated with sarcomas and glioblastomas when it is constitutively expressed.

A

C-sis protooncogene encodes PDGF

–associated with sarcomas and glioblastomas when it is constitutively expressed.

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22
Q

_-___ encodes a receptor for HGF.

Point mutations in _-___ are involved in papillary renal cancers.

A

C-met encodes a receptor for HGF.

Point mutations in c-met are involved in papillary renal cancers.

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23
Q

Germline point mutations in _-___ are associated with

  1. multiple endocrine neoplasia (MEN) syndromes
  2. familial medullary thyroid carcinoma
A

Germline point mutations in c-ret are associated with

  1. multiple endocrine neoplasia (MEN) syndromes
  2. familial medullary thyroid carcinoma
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24
Q

Gastrointestinal tumors (GISTs)

Germline mutations in _-___ .

A

GISTs

Germline mutations in c-kit

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25
Q

[t(5;12)] generates a fusion protein between the PDGF receptor and another motif, resulting in _____ _____.

A

t(5;12) generates a fusion protein between the PDGF receptor and another motif, resulting in myelomonocytic leukemia.

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26
Q

DNA viruses and cancer

HPV - _____ cancer

EBV - _____ lymphoma; _____ carcinoma

A

DNA viruses and cancer

HPV - cervical cancer

EBV - Burkitt lymphoma and Nasopharyngeal carcinoma

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27
Q

_____ benign smooth muscle tumors of the uterus.

A

Leimyomas are benign smooth muscle tumors of the uterus.

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28
Q

A _____ is a benign mesenchymal tumor of the left atrium.

A

A myxoma is a benign mesenchymal tumor of the left atrium.

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29
Q

_____

Tumor marker for T-cell malignancies.

A

CD4

Tumor marker for T-cell malignancies.

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30
Q

HMB-45, S-100 protein

Tumor markers for _____ _____.

A

HMB-45, S-100 protein

Tumor markers for malignant melanoma.

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31
Q

_____

Tumor marker for muscle tumors.

A

Desmin

Tumor marker for muscle tumors.

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32
Q

_____

Tumor marker for medullary carcinoma of the thyroid.

A

Calcitonin

Tumor marker for medullary carcinoma of the thyroid.

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33
Q

Routes of _____ _____.

  1. Hematogenous
  2. Lymphatic
  3. Seeding of body cavities
A

Routes of tumor metastasis

  1. Hematogenous
  2. Lymphatic
  3. Seeding of body cavities
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34
Q

A malignant tumor of epithelial origin is a _____

A malignant tumor of mesenchymal origin is a _____

A

A malignant tumor of epithelial origin is a carcinoma

A malignant tumor of mesenchymal origin is a sarcoma

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35
Q

Secondary descriptors of tumor morphologic appearance

_____ : frondlike structure

_____ : dense fibrous stroma

_____ intraductal neoplasm in which necrotic material can be expressed from ducts

A

Secondary descriptors of tumor morphologic appearance

papillary : frondlike structure

scirrhous or desmoplastic : dense fibrous stroma

comedocarcinoma: intraductal neoplasm in which necrotic material can be expressed from ducts

36
Q

The definition of a benign tumor resides in its inability to _____ adjacent tissues and to _____.

The lining epithelium of a benign tumor resembles that of the normal tissue.

A

The definition of a benign tumor resides in its inability to invade adjacent tissues and to metastasize.

The lining epithelium of a benign tumor resembles that of the normal tissue.

37
Q

Histologic Features of Malignancies

_____ - lack of differentiated features

abundant mitotic activity

disorganized and random growth pattern

invasion of blood vessels and lymphatics

metastases

A

Histologic Features of Malignancies

anaplasia - lack of differentiated features

abundant mitotic activity

disorganized and random growth pattern

invasion of blood vessels and lymphatics

metastases

38
Q

Tumor markers for cancers

nuclear receptors for estrogen, progesterone : _____

Lewis a antigen (CA 19-9): _____ and _____

CA 125: _____

A

Tumor markers for cancers

nuclear receptors for estrogen, progesterone : breast

Lewis a antigen (CA 19-9): pancreatic and gastrointestinal

CA 125: ovarian

39
Q

carcinoma that does not penetrate the basement membrane

A

Carcinoma in situ

carcinoma that does not penetrate the basement membrane

40
Q

Invasion and Metastasis are Multi-Step Events

  1. Invasion of the basement membrane
  2. Movement thru extracellular matrix
  3. Penetration of vascular or lymphatic drainage
  4. Survival and arrest within circulating blood or lymph

–passage through ECM, invade thru BM–

  1. Survival and growth as a metastasis (requires angionesis)
A
41
Q

Adhesion Molecules

__________

transmembrane receptors that mediate cell-matrix and cell-cell attachment, and stimulate intracellular signaling and gene expression

A

Adhesion Molecules

Integrins

transmembrane receptors that mediate cell-matrix and cell-cell attachment, and stimulate intracellular signaling and gene expression

42
Q

Adhesion Molecules

_____ and _____

  • suppress invasion and metastasis
  • decreased expression in most carcinomas, leading to mestases
A

Adhesion Molecules

E-cadherin and Catenins

  • suppress invasion and metastasis
  • decreased expression in most carcinomas, leading to mestases
43
Q

Malignant cells make proteolytic enzymes that help degrade the basement membrane.

Examples

1.

2.

A

Malignant cells make proteolytic enzymes that help degrade the basement membrane.

Examples

  1. u-Pa (urokinase-type plasminogen activator, which converts plasminogen to the protease, plasmin)
  2. MMPs
44
Q

FGF, VEGF, TGF-beta, and PDGF all stimulate

_____ _____

A

FGF, VEGF, TGF-beta, and PDGF all stimulate

tumor angiogenesis

45
Q

The fate of foci of cancer micrometastases

A

The fate of foci of cancer micromestases

46
Q

Cancer _____ reflects cellular characteristics, like organization and cytology.

Cancer _____ refers to the extent of spread.

A

Cancer grading reflects cellular characteristics, like organization and cytology.

Cancer staging refers to the extent of spread.

T : size of primary tumor
N : regional node metastases
M : presence and extent of distant metastases

47
Q

Monoclonal Origin of Cancer: cancers arise from a single transformed cell

A

Monoclonal Origin of Cancer

48
Q

Tumor Heterogeneity and Clonal Evolution

A

Tumor Heterogeneity and Clonal Evolution

49
Q

Tumor Heterogeneity and Cancer Stem Cells

A

Tumor Heterogeneity and Cancer Stem Cells

An oncogenic stimulus to a stem or progenitor cell may lead to an expanded pool of transformed stem/progenitor cells. If a transformed cell reacquires a program of self-renewal, the resulting transformed cell may become a cancer stem cell.

50
Q

Tumor Heterogeneity and Epigenetic Cancer Cell Plasticity

A

Tumor Heterogeneity and Epigenetic Cancer Cell Plasticity

Epigenetic changes in cell populations may lead to tumor progression or cell death.

51
Q

Regulation of the Cell Cycle

A

Regulation of the Cell Cycle

52
Q

Some rare malignant clones have ______ ______, thereby avoiding senescence and leading to cell immortalization.

A

Some rare malignant clones have activated telomerase, thereby avoiding senescence and leading to cell immortalization.

53
Q

Gene: MSH

Function?

Syndrome?

Predominant malignancies?
Carcinomas: _____ / _____ / _____ / _____
Other cancer: _____ _____

A

Gene: MSH

Function: DNA repair

Syndrome: HNPCC/Lynch Syndrome

Predominant malignancies:
carcinomas [colon, endometrium, ovary, and bladder]
malignant melanoma

54
Q

3 Mechanisms of Genetic Instability in Neoplasms

  1. _____ instability
  2. _____ instability
  3. aberrant ___ _____
A

3 Mechanisms of Genetic Instability in Neoplasms

  1. chromosomal instability
  2. microsatellite instability (secondary to abnormal DNA mismatch repair)
  3. aberrant DNA methylation
55
Q

NORMAL human genes involved in cellular growth regulation, proliferation, gene expression

_______

MUTANT versions of these genes

_______

A

NORMAL human genes involved in cellular growth regulation, proliferation, gene expression

Proto-Oncogenes

MUTANT versions of these genes

Oncogenes

56
Q

_____ _____

c-myc is a protooncogene on chromosome ___

t(8,14) results in c-myc activation and constitutive expression
(overproduction of normal gene product)

This leads to emergence of a dominant clone of B cells, driven relentlessly to proliferate

A

Burkitt’s Lymphoma

c-myc is a protooncogene on chromosome 8

t(8,14) results in c-myc activation and constitutive expression
(overproduction of normal gene product)

This leads to emergence of a dominant clone of B cells, driven relentlessly to proliferate

57
Q

The activation of the ___ proto-oncogene is the most frequent dominant mutation in human cancers.

A

The activation of the ras proto-oncogene is the most frequent dominant mutation in human cancers.

58
Q

The two-hit origin of retinoblastoma: The tumor suppressor Rb gene on chromosome 13.

The function of Rb genes is a critical checkpoint in the cell cycle, and ______ mutations in Rb permit unregulated cell proliferation.

A

The two-hit origin of retinoblastoma: The tumor suppressor Rb gene

The function of Rb genes is a critical checkpoint in the cell cycle, and inactivating mutations in Rb permit unregulated cell proliferation.

*Loss of Heterozygosity*

59
Q

Susceptibility to retinoblastoma is inherited in a _______ fashion because it is the heterozygote that develops the disease.

But the genetic defect in the tumor itself is _______.

A

Susceptibility to retinoblastoma is inherited in a dominant fashion because it is the heterozygote that develops the disease.

But the genetic defect in the tumor itself is recessive.

60
Q

The p53 tumor suppressor gene is the principal mediator of growth arrest, senescence, and apoptosis.

Most human cancers display either

1) inactivating mutations of p53
2) abnormalities in the proteins that regulate p53 activity, such as _____ and _____.

A

The p53 tumor suppressor gene is the principal mediator of growth arrest, senescence, and apoptosis.

Most human cancers display either

1) inactivating mutations of p53
2) abnormalities in the proteins that regulate p53 activity, such as MDM2 and ARF (p14)

61
Q

Syndrome: familial adenomatous polyposis

Gene: ___

Protooncogene or Tumor Suppressor?

Predominant cancer: ________

A

Syndrome: familial adenomatous polyposis

APC

Tumor Suppressor Gene

Colorectal carcinoma

62
Q

Gene: WT1

Predominant malignancies: _____ ; ______

A

Gene: WT1

Predominant malignancies: Wilms tumor, AML

63
Q

Gene: BRCA1, BRCA2

Oncogene or Tumor Suppressor?

Predominant cancers: _____, _____

A

Gene: BRCA1, BRCA2

Tumor Suppressor

Predominant cancers: breast, ovarian

64
Q

Syndrome: Cowden syndrome

Gene: _____

Oncogene or Tumor Suppressor?

Predominant malignancies: _____, _____, _____

A

Syndrome: Cowden syndrome

Gene: PTEN

Tumor Suppressor

Predominant malignancies: colorectal, breast, thyroid

*PTEN is an important suppressor of sporadic (non-hereditary) tumor development.

65
Q

Syndrome: Neurofibromatosis type 1

Gene: ___

Oncogene or Tumor Suppressor?

Predominant malignancies: _______ sarcomas

A

Syndrome: Neurofibromatosis type 1

Gene: NF-1

Tumor Suppressor

Predominant malignancies: neurogenic sarcomas

66
Q

Syndrome: Von Hippel-Lindau

Gene: ___

Oncogene or Tumor Suppressor?

Predominant malignancy: _______

A

Syndrome: Von Hippel-Lindau

Gene: VHL

Tumor Suppressor

Predominant malignancy: renal cell carcinoma

67
Q

Most cancers display global _____methylation compared to normal tissue.

A

Most cancers display global hypomethylation compared to normal tissue.

68
Q

_____-_____ _______

Process by which malignant epithelial cells adopt a disguise as single, nonpolarized, mobile mesenchymal cells. This process is facilitated by loss of E-cadherin.

A

Epithelial-Mesenchymal Transition

Process by which malignant epithelial cells adopt a disguise as single, nonpolarized, mobile mesenchymal cells. This process is facilitated by loss of E-cadherin.

69
Q

Viruses and Cancer

HBV and HCV - _____ carcinoma

HHV 8 - _____ _____

A

DNA Viruses and Cancer

HBV and HCV - Hepatocellular carcinoma
HBV = hepatitis B virus (DNA virus)
HCV = hepatitis C virus (RNA virus)

HHV8 - Kaposi sarcoma
HHV8 is also implicated in “primary effusion lymphoma” and “multicentric Castleman disease”
HHV8 = human herpes virus 8

70
Q

RNA retrovirus and Cancer

HTLV-I : ____ leukemia/lymphoma

A

RNA retrovirus and Cancer

HTLV-I : T-cell leukemia/lymphoma

HTLV-I = human T-cell leukemia virus type 1

71
Q

Oncogenic DNA viruses have genes that encode protein products that bind to and inactivate the products of _____ _____ _____.

A

Oncogenic DNA viruses have genes that encode protein products that bind to and inactivate the products of tumor suppressor genes.

72
Q

The most common neoplasm associated with AIDS is _____ _____.

The virus associated with this cancer is _____.

A

The most common neoplasm associated with AIDS is Kaposi sarcoma.

The virus associated with this cancer is HHV 8.

73
Q

Chemical Carcinogens

PVC factory workers : _____ _____

A

Chemical Carcinogens

PVC factory workers : hepatic angiosarcoma

74
Q

Chemical Carcinogens

Alkylating agents used in chemotherapy carry a significant risk of _____.

A

Chemical Carcinogens

Alkylating agents used in chemotherapy carry a significant risk of leukemias.

75
Q

Chemical Carcinogens

Aflatoxin B1 is a potent _____ carcinogen, and is especially common in parts of Africa and Asia. Aflatoxin B1 is formed in vegetable foods exposed to warm, moist conditions.

A

Chemical Carcinogens

Aflatoxin B1 is a potent liver carcinogen, and is especially common in parts of Africa and Asia. Aflatoxin B1 is formed in vegetable foods exposed to warm, moist conditions.

76
Q

Chemical Carcinogens

Occupational exposure to aniline dyes can result in _____ cancer.

A

Chemical Carcinogens

Occupational exposure to aniline dyes can result in bladder cancer.

77
Q

Chemical Carcinogens

Nitrosamines may play a role in _____ neoplasms.

A

Chemical Carcinogens

Nitrosamines may play a role in gastrointestinal neoplasms.

ex: high incidence of esophageal cancer in Hunan province of China due to high dietary content

78
Q

Chemical Carcinogens

Nickel/Cadmium metals are associated with _____ cancer in factory workers.

A

Chemical Carcinogens

Nickel/Cadmium metals are associated with lung cancer in factory workers.

79
Q

Physical Carcinogens

Asbestos causes _____.

Asbestos is widely used in construction, insulation, and manufacturing.

A

Physical Carcinogens

Asbestos causes mesothelioma.

80
Q

Tumor-_____ antigens represent somatic mutations or alterations in protein processing, unique to tumor and patient.

A

Tumor-specific antigens represent somatic mutations or alterations in protein processing, unique to tumor and patient.

81
Q

Tumor-_____ antigens reflect the production of normal proteins, either in excess or in a setting different from their normal expression. These antigens are recognized as “self” by the immune system, and thus do not lead to effective immune responses.

ex: oncospermatogonial antigens
differentiation antigens
oncofetal antigens
overexpressed antigens

A

Tumor-associated antigens reflect the production of normal proteins, either in excess or in a setting different from their normal expression. These antigens are recognized as “self” by the immune system, and thus do not lead to effective immune responses.

ex: oncospermatogonial antigens
differentiation antigens
oncofetal antigens
overexpressed antigens

82
Q

Cancer is often accompanied by an _____ metabolic rate, which may explain the paraneoplastic syndrome of anorexia, weight loss, and cachexia.

A

Cancer is often accompanied by an evelavted metabolic rate, which may explain the paraneoplastic syndrome of anorexia, weight loss, and cachexia.

83
Q

Paraneoplastic Syndromes

Cushing Syndrome results from ectopic secretion of _____ by a tumor.

  • hypokalemia
  • hyperglycemia
  • hypertension
  • muscle weakness
A

Paraneoplastic Syndromes

Cushing Syndrome results from ectopic secretion of ACTH by a tumor.

  • hypokalemia
  • hyperglycemia
  • hypertension
  • muscle weakness
84
Q

Paraneoplastic Syndromes

Inappropriate antidiuresis is associated with production of _____.

The tumor that most often produces this syndrome is _________.

A

Paraneoplastic Syndromes

Inappropriate antidiuresis is associated with production of ADH.

The tumor that most often produces this syndrome is small cell lung carcinoma.

85
Q

Paraneoplastic Syndromes

The most common cause of hypercalcemia is the secretion of a PTH-like peptide by an _____ tumor, such as small cell lung carcinoma or breast adenocarcinoma.

A

Paraneoplastic Syndromes

The most common cause of hypercalcemia is the secretion of a PTH-like peptide by an epithelial tumor, such as small cell lung carcinoma or breast adenocarcinoma.

86
Q

Paraneoplastic Syndromes

Venous thrombosis is usually associated with _____ carcinoma.

A

Paraneoplastic Syndromes

Venous thrombosis is usually associated with pancreatic carcinoma.

87
Q

Acanthosis nigricans is frequently associated with _____ carcinomas.

A

Acanthosis nigricans is frequently associated with gastrointestinal carcinomas, especially stomach cancers.

CK Heme Onc (13 decks)

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